“The thing about twins is they invite comparison. Even though they may look identical, one usually has the edge — a little more confidence, a quicker smile, perhaps a bit more talent.

As babies and little girls, Pam Wagner and Carolyn Spiro were like that. They danced and acted and held promise that delighted their parents. They loved it when people mixed them up. They were a tight club of two.

And then in adolescence, Pam, the one with the edge, lost touch with her own mind. Life became confusing and the twins’s lives took separate paths, diverging and then intersecting repeatedly, as they once again do now. Pam is a poet and Carolyn a psychiatrist. In midlife, they’ve come together to write a book, to try to capture their story for the benefit of others, and also for themselves.

Their story is a tale of the inseparable bond of sisters, of twins, and their struggle when their lives became anything but identical.

• • •

When you enter Pam’s apartment you can’t escape the photo test: two adorable baby girls, ribbons in downy hair, one gazing intently, the other head-tilted, tentative. Both bright-eyed, identical. Which is which? Which is Pammy and which is her twin, Lynnie?

You can’t tell. Is that thoughtful tilt a Lynnie trait? The more focused expression Pammy’s? Impossible to say, so you guess and you guess wrong.

And you wonder, was the die already cast at so young an age? Were they already – though indistinguishable on the outside – so very divergent on the inside? The seed of illness, perhaps, already planted; the roles of caretaker and cared-for so early ordained. You try to reconcile these photos – these identical babies and later, mirror-image school girls – with all you see a half-century later.

So very different are they now. How do they live with this, the undoing of their twinhood? And, how has their family, so accomplished and talented, coped with the slap of fate? That one became psychotic, the other a psychiatrist. Pam catches you staring at the beguiling babies. “You know,” she says, “I was well once.”’

click on link above to find rest of story, written after a years long series of interviews, both at home and in hospitals.

I cannot find the email or the name of the person who mailed me wanting a print of this piece, but I wanted to inform her that art prints and other posters etc are now available at this link at Redbubble.com. Also posted at Zazzle.com.

This is only part of what i have not been able to write about for months. And there is a great deal more. Now that “Mike” is formally being charged with Assault, i feel i can share this much. In the future i will say more. But for now, at least i will share this statement that i wrote for the police, some weeks later, which is only a second statement, as they already had the statement I originally wrote the very day the assault happened.

Alas, I do not have a copy of that statement, which another ER nurse had to transcribe for me as I was not permitted the use of an ink pen at the time. It was also after I had been illegally but forcibly administered IM Haldol, despite the fact that the record itself shows that I was lying on my bed in my room with my headphones on and the lights off. The record also shows that an order for PRN 4-point restraints was entered into my chart at that same time. And this PRN order was kept there for the entire 8 days that I was held captive in that Emergency Room, a matter that the lawyer’s grievance deals with but for which a mere grievance seems hardly adequate.

Let me start at the sort of beginning, which is to say only that I had been hospitalized by force at R— at the State Hospital Unit there — and I will talk about that experience in a whole different post. But after 6 weeks I was discharged to a step down facility largely because I had so alienated the hospital doctor that he wanted to get rid of me…Let’s face it. I told him each time I saw him, “Get lost, I do not want to talk with you, You are useless!” Needless to say, this did not go over well, useless though he may have been. And though I found the Social Worker very helpful and so too many of the nurses and mental Health workers and the Occupational Therapist was wonderful as well, but ONLY THE DOCTOR mattered. At least in his own mind, and so he arranged to discharge me somewhere I would no longer get under his skin or on his nerve i.e. anywhere but in his hospital!

That this step down facility had no medication supervision, beyond opening a safe and having a resident take whatever she or he wanted, this mattered little to the doctor, apparently. Despite his insistence that I needed the medications to such an extent that I have been on a so-called ONH or “order of non-hospitalization” for months now, meaning that wherever I am, I can be hospitalized if I do NOT take the meds, as contradictory and gobbledigoookish as that sounds! SO I was sent off to R–, Vermont, to await a bed first at Alternatives and then a more or less long term placement at MRR in Brattleboro, where I am today. (Though how I got here was not via that route as it turned out.)

But in R, Vermont, I did not last longer than a week at the step-down facility as I failed to take the meds and I suppose this is why I ended up trying to set my hair on fire, after receiving commands from “on high.” That is also why I was at the ER when what I describe below occurred.

I knew when the staff member left me alone in the ER, after she walked away and left me there, that I was sunk, that I was going to end up back in the hospital, and with that realization, my heart plummeted. I did not want this, I did not want it. I decided then and there to do all i could to be compliant with the doctor and the crisis team, even more so than I already had been, which was plenty. I asked if I could take 10mg of Zyprexa. I even suggested it before the Crisis Team could get there. But it did me no good. They took one look at the report from the step-down facility staff member, who told them about how I had waved lit cigarettes near my just-washed hair and singed it, and they decided — in the lingo of Emergency Crisis teams, that I was “a danger to myself” and could not leave and had to be hospitalized against my will. This would not do. I said as much. I said,”I do not want to go to any hospital. I do not do well in hospitals. I want to go back where i was. Please do not make me go to a hospital. I want to leave”. And with that. I got off my gurney, as I recall, and I am sure the hospital chart can correct my memory if faulty for details now, and proceeded to walk slowly towards the door. I walked slowly because I did not want to trigger an assault by the goon squad. And I did not want to scare anyone into thinking I was doing anything besides deliberately and consciously choosing to leave. But as I did so, a man, a nurse, followed me. I walked slowly out the main door, still dressed in hospital pajamas, since where was I going to obtain any clothing? And I took about 10 steps when he yelled at me, “You go any farther and I am calling the police!”

Now I will let my statement take over the account.

“I want to scream to someone that i saw in the eyes of the nurse who attacked me someone who recognized Satan and that was why he started screaming at me so uncontrollably before i did anything as “Pam” to “deserve it.” Do you understand this? This should have been obvious to anyone watching the video, but i do not yet know where we go off camera…i only know these facts: that he told my body that if it took another step away from the hospital (i had already walked slowly out the main hospital doors) he would call the police. I believe i shrugged and said, “Go ahead and call them.” Then i decided, remembering the Springfield VT police brutal tactics not to trust them in R—– and so i turned around maybe fifteen feet from the double doors deciding to return and proceeded, again slowly, back towards the entryway. It was then that this nurse started to scream at me. i was shocked at this, because i had already reconsidered and was returning under my own steam. i objected to his screaming and i asked him, likely also loudly, why he was screaming at me when i was already complying. He continued screaming even louder and then he grabbed me and bear-hugged me in a suffocating restraint hold that set me off big-time. He is a big man, and i could not get away from him. He dragged me into the hospital lobby, where, desperate for release, i kicked backwards at his shins.

This must be what so enraged him that his reaction was to throw me forcefully to the ground and jump on top of me, mashing my face into the carpet in such a frenzy that i feared he was going to kill me. I could not breathe or even scream for several long seconds as he continued to grind my face into the carpet. I was terrified for my life and did not know when or whether he would stop. Finally –i never knew what made him stop – maybe someone came out of the nearby ER and saw him attacking me? Whatever was the case, he hauled me back to my feet. At this point i was breathless and extremely frightened, but i nevertheless screamed at him in fury, “You rapist!” I may even have screamed, “You fucking rapist!” I really don’t know. I only know “rapist” was the worst thing i could think of to call him as he had violated every ethic of nursing and emergency care-giving possible and as far as i was concerned he had raped me just as completely as any man who violated my sexual parts.

Unfortunately for me, this only served to further inflame a man already too out of control for explanation, except as someone who felt face to face with Satan: his reaction was to haul off and slap Pam’s face, to shut her up, grabbing my mouth so i couldn’t scream that word any longer.

Maybe someone came out and helped her at this point but I do not recall, even though it might have happened. The next thing i remember is screaming from inside my room in the Emergency Department for a long while and when the police officer appeared, begging him to listen to what the nurse had done. He clearly did not believe me. All he did was leave a statement form for me to fill out –i repeatedly informed him that the Emergency Department staff did not permit me access to pens — and he told me i would have to somehow transmit my statement, signed and notarized, to the police station on my own.

In the meantime, i overheard the same nurse, who i believe was called Mike, telling falsehoods about how i had run into traffic while heading towards the train station. I objected loudly and vociferously. All i got for this was to be restrained yet again, this time by the same police officer among others, and despite my repeatedly asking what medical emergency justified it, to be forcibly injected with Haldol, a medication that my Advance Directive — which the ED had noted and logged in that very night– explicitly directs is never to be administered. This same drug was given to me against my will and over my strenuous objections, even though i lay on the bed the whole time. I was not overtly agitated by this time. At no time was i was more than tearful and most certainly never out of control.

I later complained of ribs (left ) pain — from how hard Mike had compressed me either in his restraint hold or when jumping on top of me, and knee abrasions (right) the latter from being dragged on the carpet. i told the ED personnel several times that night and over the next few days i spent in the Emergency Department. They never looked at my ribs or my knee to appraise these injuries, not until a few days later when Dr Sandy C—— ordered x-rays.
Because no one would document these injuries i was forced to photograph them myself in the mirror.

The pictures below are actually only 2.5 by 3.5 inches and are artist trading cards. I drew many of them, especially when I did not feel like working on my larger drawings at the hospital.

In mid-February, after a week out of the hospital (and you can read about my hospitalization by scrolling down to the previous post, but, in brief, this had been at Hartford Hospital’s Institute of Living, during which I was kept in seclusion for the larger part of a four week stay and put multiple times, sometimes twice a day for many hours in 4-point restraints. Why? Why? Although I ONCE threw a chair, they told me it was for “not following directions.” To add insult to injury, every incident in which they restrained me was accompanied by three injections in the buttocks of Haldol, Ativan and Benadryl, despite my policy of passive, completely non-violent non-resistance.)

In any event, in mid-February, after I had spent just a week at home, I became acutely psychotic again, and in consultation with the only doctor I trust, a friend drove me to Yale New Haven Hospital’s emergency department. There, after a very long and arduous wait — alas, I cannot say much that is good about Yale’s ED. It felt like the psych/alcohol patients – and there were no discriminations made between the drunks and anyone else — were lined up on their beds in the hallway like buses at a terminal for what felt like “miles.” In fact at one point there was probably a line 15 gurneys long snaking around the corner until I could not see the end.

I was there for two and a half days, maybe longer, I do not recall. In fact, I remember nothing about my ED stay after I was finally “admitted” to the actual psych portion of the ED, as opposed to the hallway. I believe I was finally given medications, but also that I was no longer permitted access to my artist crayons, which meant that I only wanted to sleep and likely did until I was admitted to the Yale Psychiatric Hospital, a street or two away.

To say that my experience at YPH was an order of magnitude better than it had been at the IOL or even at Natchaug Hospital is truly not to give YPH enough credit. I scarcely want to mention the other two hospitals in the same sentence, that is how different Yale is and I say that even though I once considered Natchaug my “gold standard.” No longer, no longer. I think Natchaug was decent once, but only because of the civilizing and humanizing effects that the director of nursing, Sharon Hinton, APRN, had on the hospital. Once she left, the whole place went to pot, as evidenced by my experience during the last two stays, which went progressively from bad to terrible without her there…literally without her protection I was brutalized by a dehumanizing medical staff that had been left to do whatever it wanted to on its own, to hell with the consequences to the patients.

Be that as it may, and we know that the Institute was never humane, Yale took me completely by surprise. I was hard to surprise, and hard to convince that they were for real in their gentleness and kindness, let alone in their determination to treat me and everyone there with respect and dignity. I was certain that they would prove me right, that SOMEONE would be put into restraints, that someone would be violent enough to push their buttons and get 4-pointed. But it never happened, not in the entire three weeks I was there. Not even when a patient threw a punch or a push. Not even when a patient screamed bloody murder or used foul language. Nothing that earned me or anyone else seclusion or restraints elsewhere even came close to pushing the staff’s anger buttons at Yale. Instead, they persisted in using persuasion and gentleness and kindness…and if anyone lost it, if anyone became angry and could not keep it together, so far as I could tell, that staff member took themselves away from the situation to cool down, and did not take it out on the patient.

The most amazing things happened. No one forced me to do anything. Not even to take medication. I agreed to take it, after some discussion with the doctor and social worker…but when I evinced some doubt about the side effects, instead of pooh-poohing them as the doctor had at the Institute, Dr Milstein agreed with me, saying that the Zyprexa definitely increased appetite, and that it was not imaginary or something that was in my control, the way Dr Banerjee did at IOL. Instead, he and the other team members not only agreed to help me control what I ate, but went out of their way – I believe they actually went “Stop and Shopping” – to provide me with my own private supply of raw vegetable snacks in the staff refrigerator to eat at any time of the day…just so I wouldn’t have to be tempted by the hospital snacks of Doritos etc.

Dr Milstein asked me not to worry about what they did or did not do “extra” for me, and I tried not to. But when two large bottles of brand name Diet Coke kept appearing for me every day, and when the resident was sent to buy me batteries for my personal pencil sharpener (with a grinder not a blade), just so I could continue to do my artwork and not rely on the staff to sharpen my pencils in the back, well, I knew 1) they were truly watching out for me and treating me with TLC, or what certainly felt like extraordinary care, and 2) they were in fact spending “extra” money, if not indeed their own money just to supply these special needs…All of which – or NONE of which would have mattered at any other hospital or to any other staff. If I had no pencil sharpener, who would care? If I had to eat hospital food, who gave a damn? Dr Banerjee basically said it was MY fault and only my fault if I gained weight on Zyprexa, that none of his other patients, the good ones, ever did. But at Yale, all these matters were important to me, and so they were important to Dr Milstein to to Chris Simpson the social worker and to the other team members. Not just as a matter of words, but to be taken care of so I could both take the Zyprexa and do art.

Just as important, Dr Milstein took at least a half hour every single day, and I think sometimes it was more than that, simply to talk with me and listen to what I had to say. Even if it was only to rant about how badly I had been treated at the IOL. He repeatedly told me that he just wanted me to learn to trust again, to believe that not everyone was against me or would hurt me…And if I did not learn that precisely, I did eventually come to believe that the staff at Yale were trustworthy and kind and meant what they said about their NO restraints and NO seclusion policy, for everyone. I may had still had frissons whenever someone screamed or threw a fit, panicking, believing that 4-point restraints were finally going to be resorted to. PTSD is not that easily overcome after all. But I grew more trusting, and by the time of discharge, I was able to thank them all for everything, to know that they had gone out of their way for me, and not feel too guilty.

I did a fair amount of art while I was at Yale Psychiatric Hospital. I will post more in the coming days.

These are the first two pages, including a note from the cover page, of my very very detailed Psychiatric Advanced Directive, and I think you will see why what happened at the Institute of Living, the psychiatric section of Connecticut’s Hartford Hospital, NEVER should have happened. Not only did I bring a hard copy of this PAD, but I wore a medical bracelet with a code for a very complete online medical record, with uploaded documented evidence, both of narcolepsy diagnosis and need for medication, proof from longtime outside mental health providers that I do NOT have “borderline personality disorder,” and other such assistive documents…ALL were soon ignored completely in the effort to discipline and punish me “for not following directions” i.e. not getting better fast enough and speaking my mind to the psychiatrist.

__________________

Prominent NOTE on cover page:

Miss Wagner has experienced multiple episodes of severe psychological and physical trauma. She must NOT be subjected to either physical or mechanical restraints or involuntary seclusion at ANY time. The use of either imposes a serious risk of re-traumatizing and injury, leading to regression and severe worsening of symptoms.

Pg 2.

HOW TO INTERVENE IN A CRISIS:

DE-ESCALATION IS ESSENTIAL

1. PLEASE REMEMBER: I can calm down if YOU follow these steps and do not threaten me, order me around, or approach me in anger or in fear.

I need one person to talk to. I should be approached calmly, by someone who will speak in a kind and respectful manner, understanding that above all:

I AM SCARED and my anger masks fear. I am not dangerous. I WILL ONLY FIGHT IF YOU ATTACK ME. Please remember that any show of force and people ganging up on me to administer forced medication will be felt as an attack.

I can be persuaded to take oral medication, usually, if this is negotiated with dignity and kindness and not by means of threats.

DO NOT ISSUE ULTIMATUMS you won’t back down from…That will push me into a corner and you too, and will serve nothing but to escalate the crisis.

A calm unthreatening and unthreatened person should ask me calmlyand patiently if I can speak in a lower tone of voice, so she can hear me better. Ask me if I can take a deep breath and try breathing techniques that will have flown my head in the moment of crisis.

Should you have a COMFORT room available, you can guide me gently to it but do not close me alone. Make sure I am warm…

ABOVE ALL YOU NEED TO BE PREPARED TO LISTEN TO ME.This is not just a matter of forcing medication. Medication may not even be needed if you hear what is going on and what the problem is.

If you take these simple steps, it is virtually guaranteed that the situation will resolve calmly and without any need to resort to the sorts of violence that would permanently damage and re-traumatize me (or produce secondarily negative behaviors afterwards): seclusion, forcible injections, or mechanical restraints or physical holds.

p 3

STATEMENT TO CAREGIVERS

It is vitally important that you understand that despite a few previous in-hospital assessments, I do not have a personality disorder, borderline or otherwise (you can confirm this with any of my longtime outpatient providers) and that if my behavior seems out of control, it is because I am out of control: I literally do not at the time know what I am doing or why. I am not manipulative or attempting to achieve secondary gain. The fact is I have had tertiary CNS Lyme disease and after positive PCR and Western Blot tests during treatment, I was informed the condition is likely incurable. (Dr ******* of ****** NY, will confirm this.) During the initial illness, my brain developed multiple lesions, visible on MRI, which may predispose me to temporary emotional and behavioral extremes and abnormalities but these are NOT my norm. Anyone who knows me well would confirm this, if you asked them.

You need to understand that I am not always able to communicate the extreme fear I feel, the global paranoia that I experience, but because I feel so threatened and unable to communicate clearly about it I may become very angry at the hospital situation. I am not an angry person. I do have trauma issues, as many people do, which may be exacerbated by being in the hospital.

Please be aware in advance that my “memory in the p.m. for what happened in the a.m.” is often faulty. That is just how it is. When in crisis, I have little ability to recall from moment to moment what happens. This is why it is essential that I be able to write things down. I have lost many years to this amnesia and if I suffer additional trauma it will only make it worse.

I beg of you, do not make assumptions about me. Do not make assumptions about my state of mind. Do not “put two and two together” in your mind without asking me if the conclusion you have drawn is the correct one. You do not know what is inside my head without asking me.

Ascertain whether the information you have at hand is correct. Too many records and hospital charts have been drawn up (because “patient is not communicating”) on faulty information from earlier charts or information gleaned from others but not from me, and the consequences to my treatment have been devastating. PLEASE CHECK MY INTERACTIVE HEALTH RECORD ONLINE at www. — .com Use code ***** to get access.

I have been traumatized by abuse, sexual assault and by brutal treatment in hospitals, from being deliberately choked and given forced ECT to being kept in four-point restraints for several days at a time. So if I experience seclusion or restraints or even that euphemistic obscenity called a “therapeutic hold” it will be devastating and counterproductive. Such treatment invariably leads to increased anger, regression and worsening of symptoms, and my behavior becomes unpredictable afterwards. This is a response to trauma NOT because of any inborn temperamental disorder. I have already outlined a better way to deal with me and help me on page 2.

I KNOW YOU MAY NOT APPROVE OF POLYPHARMACY. But you need to understand that I must take the antipsychotic drug combination: Abilify 15mg with Geodon 160mg, a TWO-Drug regimen. Monotherapy does not work. I have tried many solo drugs over the course of 4 decades – Thorazine, Mellaril, Haldol, Prolixin, Clozaril, Risperdal, Seroquel, Zyprexa and others – ALL monotherapy has failed.

I will not take any drug that induces weight gain. If you force the issue, know that it will be a useless endeavor because I will stop taking it immediately upon leaving the hospital.

Finally, understand that if I am here in the hospital it is for a reason, and I want only one thing: to get better and be out of here as soon as possible. You can traumatize me and worsen my symptoms and keep me here too long, or you can work with me to achieve my goal, which should be the same as yours. I don’t see any other alternative.

Respectfully,

Pamela S. Wagner

Now, I think that is about as crystal clear as it can be, no? And indeed, Dr Banerjee, my first psychiatrist LOVED it. Said so, and raved about how complete both were, both the PAD and the online medical history which he downloaded, printed out and brought with him to our first consultation. So what happened? YOU tell me! I will write more about what I think happened later. I am still trying to figure it all out.

The above is are just some bruises of many I received during my month-long course of “psychiatric treatment” at the Hartford Hospital’s Institute of Living, on the unit called Donnelly 2 South. In Connecticut, the Institute of Living, first known as the Retreat, and once quite famous as a posh sanatarium for the rich and famous though this is no longer true, was first made famous by Clifford Beers, I believe, who wrote about similiar torture he underwent there just a hundred years ago in the book, A Mind That Found itself.

After burning my face with cigars and cigarettes, I spent the last month in Connecticut’s well-known Institute of Living (yeah the dangerous 6th month was JANUARY not February but nobody thought to check my math) being beaten up and trussed like a pig in four-point restraints almost daily for many many hours. Why did they deal me this sort of treatment? Why? Because “You do not follow directions”.

I DID NOT FOLLOW DIRECTIONS so they beat me up and tied me, shackled me with leather and metal cuffs to a bed for dozens upon dozens of hours.! Get that? I was disobedient, so they shackled me to a bed as an excuse for treatment!

After this experience, I LOST ALL FAITH in the ability of any institution to do anyone any good who has a mental illness or sickness of the mind, or any emotional disorder or whatever you wish to call it. I GIVE UP! I will kill myself if anyone ever tries to send me back to such a cesspit of a place. I do not care if it is appointed like the Taj Mahal. NO ONE who works there is uncontaminated by the evil infecting such places and they are ALL EVIL EVERY SINGLE ONE. I have NEVER been to a hospital where the people are kind and well meaning and where the treatment is actually kind and decent. Once in a while a single person, such as the Middlesex Hospital occupational therapist Christobelle Payne, may stand out in memory as being a rare human being of warmth and dignity and caring, but otherwise, they all to a one fail the test of being decent human specimens and all fail royally to be even normally humanly responsive to suffering persons. They are in it for the money and a cushy job, and don’t you forget it if you go into a psycho hospital, DO not expect to get well there. Expect PILLS, and directions (ie ORDERS) that you HAVE To follow or ELSE.

Get out of there as quickly as possible, because your life depends on it. I am serious. DO NOT LINGER expecting care and treatment or to feel better no matter how helpful it might want to seem.

Furthermore. if you are a young person, do not listen to the sweet seductive advice that some may give you that you woul do well to go for “disability” and social security payments. THAT Is a load of total crapola and the worst thing anyone could tell anyone under the age of 50. I am so angry and broken at the moment that I cannot speak more. But if I can later on, I will say more to explain. At the moment, I have to attend to too many PHYSICAL bruises and to find a way back to sanity on my own, havin been driven to the brink of near extinction by one of the best known hospitals in this state. At the moment I am both rigid with rage and so confused and broken that I scarcely know how to continue, or whether I even want to. Why bother? Why bother? How can people be such monsters, and in such monstrously powerful places and ways. I hurt so deeply and feel I will never trust an single person ever again when they say, Come let us help you. You need our help. YOUR help? Like being raped, I need your F—ing help!

GO jump in a lake of snot is what I should say to all of you so called helpers. I’d rather die. Go F— yourself.

This is the front entrance to Natchaug Hospital, a photo I cribbed from their Facebook page. I am trying to paint it, but that will take a while so for now, this will have to do…Hope I am not infringing a copyright. However, as this post is all about Natchaug it is good publicity too!

After I wrote my early September post “Open Letter to Deborah Weidner MD”https://wagblog.wordpress.com/2012/09/02/open-letter-to…chaug-hospital/ ‎about my stay at Natchaug Hospital in August, I received a phone message one Saturday afternoon not long afterwards from none other than Dr Weidner herself. She left her cell phone number and asked me to call her back. Her voice was neither angry nor upset, quite the contrary, she sounded very pleasant. So, despite my heart’s clangor in my ears at the same time as it drove nearly into my esophagus with its nervous pounding, I sat down and decided to make the call “without further ado.”

“May I speak to Deborah Weidner?” I asked the voice who answered, intentionally using her first name, so she would not think I was calling on unequal terms, i.e. as a patient.

She responded, and addressed me as “Ms Wagner,” which made me feel better at once. Then, before I said a word, and believe you me, I was not going to be the first to speak in any event, she said (and I quote from a less than perfect memory here, so this is not verbatim), “I read your blog post. You are such a gifted writer. It was really a wonderful piece…” Or words to that effect.

I was both stunned and amazed. Certainly I was amazed this was the self-same “head honcho” who had essentially, so I’d felt in August, been against me at the hospital along with so many others in charge, the MD who had – I felt – given up on me, called me “a borderline”*** and gotten rid of me at the earliest possible opportunity. She could, back in August, so easily have tried to help, tried to find out what had gone wrong and make things better. But it seemed to me at the time that she had simply gone along with the general ill-will towards me and dumped me, no matter how troubled I still was.

Note that when I say, “general ill will” I mean exclusively “the management” — the doctors and social workers and APRNs…those who did the diagnosing and disposing. From the nurses and mental health workers I felt nothing but great support and goodwill, almost to a one (minus, of course, my abusers). Even of the nursing supervisors I found only that single really awful one…at least to my face.

But as for Dr Weidner, I’d felt that she too had decided to “blame the victim” instead of taking responsibility for the very real traumas, which certain “bad egg” hospital staff had inflicted on me…

However, be that as it may, it is all water that has sluiced beneath the bridge, and so as I said, I was stunned to receive Weidner’s phone call. I was even more astonished to perceive such humanity and even warmth from this woman against whom I had conceived such animosity and from whom I had felt the same.

Here she was not only praising my writing skills but speaking approvingly of a blog post that concerned my very negative month-long stay in “her” hospital.

We talked for a while. She may not have known it but I was trembling, both with anger and with anxiety. It took me some time to calm myself, to feel safe enough to answer any of her questions. Finally, she said what she evidently had called about to begin with. “I wonder if you would consider coming back to talk with me and a few other interested people here at Natchaug. I would really love to speak with you.”

I was dumbfounded for a minute. But only for a minute. Then I found my voice, and as soon as I did, I responded with enthusiasm. “Yes, absolutely. I would love to do that. Thank you. I would be more than happy to speak to you and anyone else who would listen to me.”

“Thank you, Ms Wagner. We really want your input, we want to make Natchaug a better place and I think your insights can help us to do that.”

After we hung up, I was beaming. I felt so filled with light that my smile must have been big and bright as a beneficent Halloween pumpkin. I immediately went downstairs to the 7th floor to share the news with my friend of 30 years, a friend who had been appalled when I came home in August in such terrible shape.

_________________________________________________

Well, that meeting took place yeseterday, Friday, at 9am. Brityn, my case manager drove me out to Natchaug, and I brought with me the oil pastel painting I’d done while there, the view of the nurses station from my room. I am donating it to the adult unit mental health workers’ breakroom, after Brian, the patient relations advocate, who is both intelligent and caring and an extraordinary listener, displays it somewhere publicly for a time.

When we got there, we were met by the director of nursing, John O, APRN. Shortly thereafter Dr Kline came along and we went into a little room off the lobby. I was a taken aback at first when, while waiting for Dr W, John and Dr Kline started talking with Brityn, as if she were the only person in the room, as if, “professional to professional,” they could ignore me, a mere patient once again.

This was unconscionable. I was the person with whom they ought to have been concerned, and instead they directed themselves wholly to Brityn. It also felt infantilizing. Why didn’t they even greet me or ask how I was doing since I’d left Natchaug? They could have at the very least made small talk with me. Instead, they chatted with Brityn, someone who is not only my junior by about 30 years, but with whom they’d had no prior interactions whatsoever and whom they didn’t even know. It was insulting.

I dunno. Maybe I was too sensitive. Maybe they just wanted to include Brityn…But it didn’t feel that way to me. It felt like they were talking to her as a way to avoid talking to me, a way to simply bypass chatting with me.

To their credit, however, when I mentioned it – “You know, I am here and I am a person too. You could at least include me in the conversation…” — they apologized. But even now I do not believe they understood the problem. They thought it was perfectly acceptable — since Brityn had driven me (I wonder how they would have behaved had I simply been able to drive myself!) — to treat me as merely a patient, a “charge,” and to treat Brityn as their equal, the other professional, the only one on equal standing with them. Well fork them…It cost me a lot to go up there, not even to talk about what they did to me. Do they really think I am OVER it? They ought to be ashamed of themselves.

But I will let that go as well.

Soooo, down to tin tacks, which turned out to be the golden glue of the meeting itself.

Dr Weidner, small and blond and –somehow I want to call her “open-faced” — she seemed not to hide a lot, had what looked like a genuinely interested and caring face, though naturally psychiatrists are trained to achieve this appearance. Nevertheless, I did trust her sincerity.

This time I cannot recall if she called me Pam, or nothing at all. I do not think she called me Ms Wagner, though. I pointed out that since I understood that the post I’d written, the “Open Letter” had essentially “gone viral” in terms of the Natchaug Hospital staff itself, I didn’t feel I needed to talk much about what had happened in August. I had written all about it in detail. Or most of it…Mostly what I thought I should talk about was “How to make Natchaug a better place.”

I did that, and in fairly great detail. I will write a separate blog about all those suggested changes, and changes which would apply in spades to other hospitals. But for now, I just want to report on the meeting itself.

Dr Weidner seemed to take careful notes and when I had finished I was simply “blown away” when she said, “Pam you have so much to tell us, and are such a good teacher, but there are only the three of us here today. How would you feel about coming back and talking to the entire medical staff? Your experience as a patient and your ability to articulate it would be just invaluable for many more of us to hear.”

Well, I almost laughed in sheer belief and pleasure. “Of course. I would love to. I do public speaking and would have no problem with that. Anything at all that I could do to make Natchaug a better place would be fine with me.”

Dr Weidner also wanted to know what they could have done to make my own stay less traumatic “from the start,” especially how they could have relieved or prevented my becoming mute for so long.

I told her that from the instant that the first episode started, when that nurse or whomever said to me, “Take your hands out from under the blankets!” I felt so betrayed, felt indeed that I was back at Hallbrooke being tortured by those two abusive staff members (who were actually reprimanded for their behavior) that I became mute at that very instant.

Would I have taken Ativan despite my psychiatric advance directive’s proscription against its use? Yes, had someone gently explained its use and suggested I take it to help my mutism, just a small dose, I would have at least considered it.

But no one presented Ativan as an option…I do not believe anyone even knew about it. Except of course to force it on me against my will during the Seclusion event I described in the earlier post. Not until Dr Cappiello insisted that I ask Dr Pentz to prescribe it, and that was only after I had been unable to talk for 8 days.

As for the mutism itself? They — Dr Pentz and some of the other docs and APRNs — insisted that I deliberately chose not to speak, that I could have if I wanted to. But in point of fact, I could not get myself to speak, I woke every morning with no “inclination” to speak and no felt ability to break that barrier…and therefore I truly could not speak at all. In fact, it took hours, and maybe two doses of Ativan before I was able to speak at all even when I did take it.

After a few more words of conversation, the meeting broke up and Brityn and I headed towards the car, with the expectation that we would come back again so I could speak to a larger group of Natchaug personnel.

So that was my reconciliation with Natchaug and I left feeling like a million dollars. Even Brityn told me it was the best appointment she had taken anyone to that week.

You know, my sole worry — and I felt a frisson even as we talked about it and my worries were not immediately allayed — was when I asked if I could ever be readmitted, ie as a patient. I know, I know, why would I even want to? Dr Weidner said she didn’t think I’d ever want to come back. According to her, that’s what I’d written in my blog post. But in fact, what I said was that I didn’t think I would ever be taken back. I was considered such a PITA, why would they want me? And also because I could not see anyone for a doctor but Dr Andrei, and it seems dubious that she would see me. Why I do not know. But so be it. I liked her, never had any problems with her. But I must have done something wrong. This is twice that they have refused to assign me to her.

In truth though, 1) I have NO WHERE ELSE TO GO, no where else I could possibly begin to trust or feel safe, nowhere do I have even a history of feeling and being safe and 2) say that they do change, where else would I want to go?

In any event, since I can work with neithe Pentz nor the other doctor on the unit, because of “conflicts of interest” (i.e. he still has “feelings for me” from our days in med school together) that leaves only Dr Andrei, and I dunno if she would accept me onto her service. So, even if theoretically they would take me back – which didn’t seem at all certain, not from the vibes I got from Dr Weidner — I don’t have any idea who could see me if I were admitted.

(What the fork! I would be stuck in a snake pit like Hartford Hospital’s Institute of Living only to be brutalized again. When push comes to shove and I might need or want to be re-admitted, frankly I wouldn’t expect the admitting MD Natchaug to give a damn, no matter how many times I’d spoken to people there and how much I might have taught them. As soon as I need their help as a patient, frankly, I expect I’d simply to be abandoned to my fate somewhere else.)

Well, of course I will still help Natchaug,. How could I not want to help them? I want to help EVERY hospital in the state become as good as Natchaug and even better. But it sucks all the same.

———————————————————————————

*** Finally I want to make a brief comment about the specific words “a borderline” used early in this post, because every time I hear this phrase it makes my blood sizzle. Not only is very insulting, it stigmaties. I may not have borderline personality disorder, but I know what is meant when someone calls a person “a borderline,” and it is invariably takes the place of PITA, Pain in The Ass.

There is a difference, a huge difference between understanding the very real travails that a person with such a personality disorder undergoes daily, the emotional suffering that afflicts that person, and simply calling them names because you find them troublesome.

Empathy goes a long way, especially with someone who suffers from BPD. The idea of calling someone “a borderline” is tantamount to saying, “I suffer from YOU.” A disgusting statement if ever I heard one, one most often made by mental health professionals. Doctors who use the words, “a borderline” need 1) re-education in language and its nuances, but 2) and much more important, a re-education in COMPASSION.

Of course, that’s just IMHO…and who am I?

I’m Nobody! Who are you?

I'm Nobody! Who are you?
Are you – Nobody – too?
Then there's a pair of us!
Don't tell! they'd advertise – you know!
How dreary – to be – Somebody!
How public – like a Frog –
To tell one's name – the livelong June –
To an admiring Bog!

All of these “trading cards”, 2.5 inches by 3.5 inches. Many were done at Natchaug Hospital and are original one of a kind art. They are for sale. Tell me which one(s) you would like. We can work it out. (Payment is always in art supplies equivalences, by the way. No “cash” or other monetary payments accepted.)

Purple Cone flowers, Best in Show, No Exit from the Bin, and Mighty Manfred Makes an Entrance

It has been a week since my discharge from the Adult Unit at Natchaug Hospital. After a week of recuperation and stabilization at home I feel compelled to write you via the open forum of a letter on this blog. It may or may not get your attention directly but I feel certain it will be read by someone on the Natchaug staff. Perhaps that way it will eventually reach your eyes. If not, so be it.

Our encounter on Monday the 27th of August was extremely brief and not particularly noteworthy. While I have much to say that never got said then, I owe you nothing, and by the same token, expect nothing from you either. That said, to any of my readers who want to understand the intent: I write partly in my defense against what I feel were gross misunderstandings (leading to unnecessary trauma), and partly to record publicly – on record as it were – what really happened over the last 4-6 weeks.

Please, Dr Weidner, or any other reader: Do not dismiss this letter out of hand as the peevish complaints of a disgruntled but troublesome patient. I understand how you might be tempted to do so, especially because you — or at least Dr Pentz and Lisa H. APRN – claimed in their infinite wisdom to be able to detect signs of an Axis II Borderline Personality disorder (despite the concomitant presence of an Axis I psychosis ). I know that labelling me “borderline” was always just another way to dismiss me and my concerns as “mere,” that is to say as meaningless or manipulative, the “mere” attention-seeking of a manipulative PITA*.

Nevertheless, it ought to have been obvious, it ought to have been needless to say — but clearly was not — that no one could possibly know what my baseline personality was like from the past four weeks at Natchaug nor in fact from any of my past four stays there. What was clear to many early on, including me, was that this hospital stay at Natchaug abounded not in norms but in extremes, from start to finish, extremes I might add both on my part and on the part of hospital staff as well.

My friends and family know that I am not generally someone who has screaming fits or throws things or strips naked and parades around in public, all modesty thrown to the wind. So too, Natchaug staff: So far as I knew or had seen since 2010, they rarely became physical with patients and not once in all the times I had been there had physical contact devolved into anything even resembling a fight or violence. Instead, kindness, compassion and empathy were the primary tools. The best staff were as slow to lose their tempers or act on negative emotions as a live gecko was to do a cancan under the noonday desert sun.

I knew those things, and until August I believed it automatically made Natchaug a superior place, a sanctuary immune to the sorts of failings I’d found in so many other hospitals. That was why I insisted on coming back to Natchaug this time even though it meant waiting two and a half days at Windham Hospital Emergency Room, never moving off the gurney in the barren cubicle I was placed in, monitored by a camera not so subtly hidden in the large TV screen. I knew of no other hospital where I could be safe, both from myself under the influence of command hallucinations, and just as important, from any staff impulses towards the use of violence to achieve control or discipline.

How could I have known that from the first morning after I arrived, staff behavior was to be stunningly “un-Natchaug-like,” as erratic and extreme as my own would turn out to be. My entire stay was in fact characterized by physical assaults by staff, punishment and trauma that began the moment I woke up that first morning. I responded poorly to this, as anyone might, by regressing into more and more primitive behaviors. But how did “you,” that is to say, the Natchaug staff, respond to me? Not by taking a step back and seeing how things could change for the better. No, instead, you, they decided to blame the victim, to say, “She’s misbehaving, she’s ‘doing these things on purpose,’ she is volatile, unpleasant and emotionally unstable…” Et Voila! There I was, diagnosed, improperly but officially with “Borderline Personality Disorder!”

As many of my readers know, I have written extensively here, at wordpress.com, Wagblog, about psychiatric units and hospitals and have until now always held Natchaug in the highest esteem. Natchaug was always the gold standard, the touchstone against which all other Connecticut hospitals were measured. I believed that Natchaug had the right ideas, the right philosophy about patient care, hired the right people and trained them properly. I trusted that the hospital understood the critical importance of trauma-informed treatment. Ever since my 1st hospitalization at Natchaug in December 2010 -January 2011, when Sharon Hinton was director of nursing, I felt I’d found a truly safe place, an asylum in the best sense of the word, where troubled patients would never be brutalized by staff more bent on coercion and a lust for power than compassionate care.

I have been hospitalized at Natchaug four times now. The first three times bore out these high expectations, but this last time was unmitigated disaster, revealing how much things have changed, and how, under the auspices of the wrong leaders even Natchaug has been willing to permit a few “bad eggs” to damage patients with impunity, rather than take an honest look at burned out employees – including those at the highest levels, RNs and psychiatrists included –keeping them tenured out of a misplaced loyalty, refusing either to re-educate them or to remove them from direct patient contact.

There were three separate instances of physical violence to which I was subjected between July 31 and August 27th . The very first morning after I had been admitted and placed on one to one for safety, I remember I sleepily turned over in bed and scrunched down again to catch a little more sleep when the person sitting with me suddenly insisted that I place my hands outside the covers where she could see them. This was a strange request, since they had been under the covers all night, right up until that second. Dumbfounded, and freezing cold, I resisted and ignored her, fairly certain that she would not make a federal case of the request once I fell asleep. Instead, she repeated herself, louder and louder. She actually approached the bed and tried to bully me verbally into putting my hands above the bedclothes, telling me that being on constant observation required that my hands be visible at all times. This was news to me. Never in my experience at Natchaug had anyone required such a thing. I continued to resist, though any impulse to sleep had left me by then. By this point, it was strictly on principle.

Well, she was intent on winning the battle and instead of negotiating a solution called in reinforcements in the persons of two male mental health workers. Unable to verbally force me to uncover myself, they initiated physical contact, attempting to pry my blanketed fingers away from the blanket in which I had wrapped myself. The female stood aside, but continued to threaten to deprive me of all coverings if I did not comply with her order. The tussle went on. I vehemently kicked at them whenever they laid hands on me, though I spoke not a word the entire time. At last, they gave in and left me alone. I never found out why. Perhaps they saw the brutality they were inflicting on me. Or perhaps they were called off. I do not know. All I know is that that particular rule was never again inflicted on me.

After they left, and a new sitter arrived, I lay in bed, breathing hard and feeling bitterly betrayed. What the F just happened? Dismayed and disappointed, I could scarcely believe I was really at Natchaug and not at the torture chamber in the south eastern part of the state again. The consequences of this betrayal left me physically and psychologically speechless. What had happened to “my” Natchaug? Try though I might to let myself talk, I remained mute for 8 days.

I won’t go into the long and involved story of the second assault, except to say that it involved poor judgment on the part of my social worker and evening nurse. OTOH, an assertion of power by another nurse assigned to me nearly twenty four hours later was overkill and an act of punishment and revenge. She can deny it left, right and silly, and maybe her RN superiors believe it, especially because they have a stake in it. But I know contempt and the smile of sweet revenge when I see it, and I knew the enjoyment in her smile that Wednesday. Assault #2, which involved a rather violent physical altercation and restraint, nevertheless had a bearing on assault #3. What follows is the story of that third assault on my person. In places I quote almost verbatim from my journal entries, which I wrote at the time. When I am not quoting, I assure you that the account is very similar to the journal’s “horse’s mouth” and merely states the same things I wrote there, but with better words and fewer punctuation marks.

I do not remember how it started. I suspect I had been screaming or yelling about something. All I know is that the RN Supervisor for the afternoon, a woman I will called Dee came into my room after my upset and just stood there. At one point in her obdurate silence, she accused me of an unprovoked attack on it the nurse, Kay, who had taken revenge on me the day before. She called Kay one of her “ best nurses.” Incensed at this I assured her she didn’t know the whole situation. When she said she knew enough, I told her to leave my room.

“I’m staying right here,” she said giving me a baleful look. I pointed out that I already had a 1: 1 and did not need a 2nd person in the room. She only continued glaring at me.

“Get out,” I screamed, “get out of here!”

No response. No reaction, except for a slight recoil from the loudness of my voice.

I threatened her then. I admit it and I am not proud of it. I threatened her. I took up a box of crayons and looked as if to hit her. Everyone cried out, “No, no, Pam!” And I put it down. But I continued to cry out, “Leave! Leave! Leave me alone!” She only stood her ground and stared.

That’s when I lost it. I picked up a chair and threatened to throw it at her. This is what she’d been waiting for. She could’ve laughed or made a calming gesture or simply backed away and let the mental health workers gently disarm me and all would’ve been well. But no, Dee liked to escalate rather than de-escalate, so she yelled out, “Escort her to the quiet room!” Before I could offer to walk there myself, Brad and someone else picked me up by the armpits not even allowing me to walk and dragged me. Because they didn’t even ask me if I would walk freely, under my own steam, I fought them, twining my legs around theirs as if to try and trip them. Then to add insult to injury they dragged the blue therapy chair out of the room instead of leaving it there for me to rock in and calm myself. Now, inside the tiny, now empty windowless cell, despite the bright mural painted on the walls, panic rose in me. I looked around, remembering how Sharon had assured me that no one would ever leave me alone in there unless I wanted them too. I begged Dee for someone to stay in there with me. Sarah the mental health worker saw the panic and offered to, but Dee was furious and ordered her out.

“No, she is to stay in here alone!” She made everyone leave, and following them out, she slammed the door shut behind her.

I was horrified. All the memories of locked seclusion returned to me in an avalanche of terror. In my mind, memory told me it would make no difference if I went to the door to beg to be let out, or for a blanket or someone to talk to. Experience, all my long experience had taught me: there was to be no mercy no help nothing would change no one would respond no help nothing no matter what I did. I was and would be abandoned to my punishment until–well–until I had no idea how long it would last. No one told me a thing. Utterly terrified, instead of banging on the door and begging for release, I backed into the farthest corner. I wanted to meld with the wall, shrink back into the wall board as far away from the room as I could get. A howl climbed my throat. I tried to hold it back but I could not. When I screamed, I screamed not to anyone or for anyone but out of sheer mortal terror, the sort of terror that any animal must feels when its leg is smashed in a trap and knows his life is coming to an end. Screaming brought no relief though. Screaming brought nothing, it certainly brought no one into the room to help me. There was only thing I could think of that would that bring relief and that was to relieve myself. So I did, in the only way I could: I stripped off all my clothing and peed a huge puddle of urine on the floor. I had to. I do not know why. Removing my underwear I found inside the crotch a forbidden pencil. I’d not been allowed writing utensils for eight long days and just that afternoon I had used this pencil to sketch my first portrait since I’d been there. I wrapped the pencil in my clothing, knowing that if someone saw it they would confiscate it again.

Too late. A commotion behind the door and they were upon me, all of them, wrestling my naked body to the floor and prying the wad of clothing from me, smashing my glasses in the process so that one lens came out of the frame. In the melee, someone grabbed my medical bracelet right off my flailing wrist. They pinned me down. I knew what they had in mind. IM meds. But no one had offered me oral medication. “I want oral meds. I’ll take oral meds you can’t inject me, you haven’t even offered me oral meds.” I asked for Zyprexa. Not Haldol or Ativan but Zyprexa, the PRN I had on order.

They refused to get Dr. T, who signed off on the seclusion without ever seeing me, to change the emergency meds — which I didn’t really need but which were going to be ordered anyway, as a mater of course — to Zyprexa despite my psychiatric advance directive distinctly requesting no benzodiazepines of any sort. However, fearing any further confrontation, I swallowed the pills. Everyone got up and left except for the nurse supervisor. I stood up and surveyed the room. Urine ran everywhere.

“How can I stay here?” I asked her. “There’s pee all over the place.”

She surveyed the wet pads and floor. “Deal with it,” she said, and walked out, locking the door behind her again.

I was spent. There was nothing left in me to fight or scream or object. I simply lay down on the mat, amid the puddles of urine and curled up in a fetal position. Sleep never came; it was too cold for that. I just lay there, eyes open, my naked back to the window. 10 minutes passed. 15 minutes. I heard the mental health worker at the window ask the supervisor if she could let me out. “She is lying there calmly, I think she’s sleeping.”

“Give her another 10 minutes,” was the reply.

Another ten minutes went by and another.

The mental health worker kept asking if she could let me out. Finally, about an hour later, the door opened and Sara entered. I didn’t bother to turn over or look at her. I scarcely raised my head.

“Pam?”

In a dull voice, I answered the requisite questionnaire, as if that were adequate debriefing. Then two other staff members attempted to clothe me in hospital issue johnnies, one over my front, one to cover the back. I allowed them to do this but as soon as they let me go and I was free to proceed out of the erstwhile “Comfort,” now Terror Room, I ripped off the johnnie coat covering my naked backside, and walked half-exposed to my room, deliberate and uncaring. Who gave a fork? What could they do to me now? What could anyone do to me? Fork everyone! They were dead to me. I was dead to them. It was over. It was over. I was dead meat. Just meat. I didn’t give a fork about anything.

More than any other incident, this one was the last straw. Whatever repercussions I deserved for threatening the RN supervisor that evening, however evil I felt for being the devil, there remained in me enough human pride to resist such treatment, enough to say that even I did not deserve to be treated as harshly as Dee had treated me. Not only did she deliberately test me, she lost her temper and I was her victim. I have reason to believe that most of the staff members who witnessed what happened that night believed she went too far. Some would actually say so in as many words to me, though others were cagey and feared repercussions should it get back to her.

All I knew was that I’d been treated like an animal. What did that supervisor or anyone else expect in response? Did she really think I would become docile and obedient, chastened, a meek and compliant patient? Violence begets violence. It always does. From then on I was not the same. I was not better either, no. I grew markedly worse, and worst of all, no one could predict anything about my behavior. No one knew what would happen next, what I would do, when I would lash out or scream or throw things or push someone or even hurt myself…None of those behaviors were “me” or even close to my usual, or baseline, but I reiterate: what do you expect: treat a person like an animal, and you can pretty much count on getting animal behavior as a result.

Dr. Weidner you do not know me. Paul Pentz, for all his discharge summaries and “progress” notes (the pages of writing are all boilerplate, meaningless, and/or second or third hand information for the most part), he doesn’t know a damned thing about me. I tried to let Lisa H, APRN, know a little, but by the time she was involved in my treatment, you were all so intent on seeing in me this mythical borderline personality, instead of a person who had been acutely and brutally traumatized at your hospital, that it was useless for me to expect anything. For all Lisa’s pretence of understanding, she had made up her mind about me before she met me. She was largely deaf and blind to everything I said that did not fit the tidy diagnostic picture: schizo-affective, with a concomitant borderline personality disorder. How convenient that you could chalk all the unit troubles up to my problem, rather than seeing it as something your hospital staff created! Blame the victim, why’ncha, instead of taking responsibility for a number of incredibly poor judgment calls on your own or your staff’s part?

Of course as many people have asked me, why do I care what you or Paul Pentz or Lisa Harrison think? Well, I do not, in fact, give a flying femptogram… Mostly I care about the decent people there — the mental health workers and the nurses who did like me and made it obvious and treated me very well and made it clear they would welcome me back (though I can never return, not now.) About Pentz and Harrison and the others I could give a ratzass. But I do, or did care about Natchaug itself, once the gold standard, for me at any rate. It was the one place where I could tell other people, “Go to Natchaug – I know people will take care of you there, people will care about you there, that’s where people will treat you well.”

The even bigger tragedy is that if no one is safe from the hospital staff at Natchaug, then the likelihood is that no one is safe in any psychiatric unit or hospital in Connecticut. Let’s face it. Not much progress, perhaps none at all, has been made since the Hartford Courant’s series of articles in 1998 called “Deadly Restraints.” My sense is, in fact, that since Mnanaged Care took over medicine, things are actually a great deal worse…Oh, sure, I was not four-pointed during the past stay at Natchaug, no they managed not to become that brutal, so far… but I was physically restrained and manhandled during all three incidents and I have been four-pointed at nearly every other hospital in the state up till 2010. So I would hardly say that that practice has gone by the wayside. In fact, in the Hartford Hospital Emergency Room back in July of this year, they threatened to four-point me just for making a nuisance of myself and being noisy…

So much for not using restraints. As for not using them as punishment? I believe that in every single case when I was subjected to four-point restraints from 1980-2010, they were used as punishment, as a convenience or in revenge… I state this categorically: that not in a single instance were four-point restraints ever truly necessary to keep me safe. They were only used because they were available and the culture on the unit permitted the employment of torture to control and discipline patients. Period.

Seclusion? This practice has only increased in usage so far as I can see. The difference is only that staffs are careful to call such barren quarters the Time-out Room, and are rarely apprised as to the legal definition of either seclusion or restraint. (BTW Time-out is a disciplinary measure used to train children to behave properly…since when did psychiatry decide that patients in adult units ought to be treated like misbehaving children and sent to time-out rooms? If you want to talk about empowering patients and not infantilizing them, you do not in the next sentence tell someone to go to the “time-out room” and stay “until I say you can leave.”).

What you, Dr Weidner et al, think about me in the end is of little consequence. I know I do not have BPD and so do the people around me that matter to me. If I care about anything having to do with Natchaug it is not your opinion of me nor your judgment or your diagnosis, I care about Natchaug because while it could and should be, it is no longer a place I trust, a place where I can direct other people for safety and compassionate treatment. Because if I am not safe from myself at Natchaug, if I am not safe from the staff at Natchaug, and I mean by staff, the doctors and nurse supervisors as well as any “rogue” RN or MHW, then no one is safe at Natchaug and no one with mental illness is safe in any psychiatric hospital or unit in Connecticut.

I was admitted last Tuesday night, the 17th of July I believe it was, to the Institute of Living, the psychiatric division of Hartford Hospital in central Connecticut. I do not remember this. The fact that I have amnesia for it and for most of the Wednesday following only occurred to me on Thursday, a day and a half later, when I wondered — the train of thought must have had to do with the seclusion episode that took place Wednesday evening and which I described in yesterday’s blog post — why they had been so violent with me, why they had so quickly secluded and threatened me with restraints in a situation that didn’t come within miles of “requiring” them. Surely, I thought, the staff member who admitted me, whoever that had been, had asked me a critical question, which is on every admissions questionnaire upon entering a psych unit or hospital these days: have you ever experienced trauma or sexual assault? (or words to that effect). I could not, and still cannot, for the life of my body or soul remember anything asked or answered at that time. There’s little left in my memory beyond a vague “snapshot” of being wheeled into The Institute of Living (hence forward to be called by its nickname The Toot or by its initials, The IOL) and my understanding that I had been transferred out of the ER. Then the memory goes blank until many hours later. Understanding only as late as Thursday that I had this gap, and pained by the violence dealt me the night before, I went up to my “contact person” and asked about my admission. Could I find out whether this question was ever asked me, and what my answers were? At first, naturally and as a matter of course, she refused. That was SOP. Refuse, refuse, and refuse. So as I stood there, earnest in my request, she seemed about to summarily dismiss it as just another bothersome demand from a too-demanding patient already much disliked by all. What did I expect, cooperation? But to my surprise, her misgivings and the flicker of irritation that had crossed her face at first changed to a flattened look of resignation. She agreed to read my answers to the questions to me. But that was all she would do, so don’t go expecting more than that.

As she read from the top, a few memories stirred and woke, but only temporarily. I fear they soon faded again into the all-white-out of oblivion. Only the trauma memories remain, for they apparently are stronger than thieving Ativan. Can I push myself to remember what her reading my answers back to me recalled to mind? She told me…what? She said that I told the admitting staff member, whom I do not remember a thing about, do not even recall if that person was male or female, doctor or nurse or what…I told that person I was not homicidal, not suicidal, not hearing voices, and that I didn’t need to be in the hospital. Three answers were true, or true enough by then. After having been nearly killed in the ER the people in my head/outside of it, who tell me to do things to myself were not so relentlessly horrible in their demands…so I was indeed no longer suicidal, homicidal or in need of hospitalization. I just wanted to get out of there and go on my upcoming writing-retreat vacation.

As I recall the little I recall now, this nurse, my “contact person” read to herself a lot of the paperwork and relatively little aloud, despite her promises. I kept asking what she had read, and prompting her to read out loud, but she let forth only a few phrases. I still do not know why… though I can guess that pretty bad things are written there about me. That would not surprise me one iota. I do not really care. They will largely be lies or descriptions of that awful scene in the ER from one very biassed point of view. No one will tell MY side of the story, that’s for damn sure. Whatever is said there will be based on what the ER personnel and the guard-thugs did to me, but if my contact person believed them reading them, and never bothered to find out the half of it, then who knows what they all thought about me, or believed…Anyhow, I do not care, because they too were thuggish, professionally and psychologically.

But the big question was yet unanswered. Had I ever in fact been asked about past experience of trauma or sexual assault? Contact Person, whom I won’t name as she was at least marginally decent to me, now seemed interested in this too, having paged through the lengthy document and not found it. She seemed puzzled, said she knew it was a standard question. She started perusing the thing again from the beginning. A minute or two later, she poked a page.

“Ah, here it is. And your answer is blank.”

“So the person just skipped over it. They just skipped it!”

“It appears so. Do you want to answer it now?” She took out her pen.

“Yes, and yes. I have experienced sexual assault three times. And severe trauma due to seclusion and restraints in many hospitals.” I looked at her. She was writing. “Tell me what you wrote.

“Experienced sexual assault. Has issues with seclusion and restraint.”

“NO! I said, it was severe trauma. I have PTSD, ask my doctor. Ask, I dunno, give me a test. I cry just talking about it. My heart rate goes up just thinking about it, even though it happened more than two years ago. It was trauma, and you cannot do it to me again!” She wrote something on the paper but didn’t read it to me. She just clicked her pen off and stood.

“Now you have your answer. I have things to do. Let’s go.” With that, and no discussion of what had taken place on Wednesday night, let alone in the ER, she hurried me out of the side office so she could go back to the nursing station to do some “real work.”

——————————

I suppose there must have been some incidents of relative kindness at the Toot. There must have been exceptions to the Hartford Hospital IOL “coal dust standard.” But only Albert, a tech, stands out. Because they injected me with too much Ativan on Wednesday pm and I was discharged Friday noon, I had very little time between the ER’s monster dose and D3South’s equally large dose of Ativan-it-Away to retain much of anything but what stood out enough to stick, and really stick tight. Their puny kindnesses mostly did not, except for Albert.

On the other hand, the sheer meanness of the staff was astounding. I had a semi-meaningful interaction — though unpleasant – in all that time with only one individual who was not programmed to speak with me. And even that started out with nastiness, though I admit it was sparked by something that was “my fault,” as you will see.

Friday morning I needed migraine meds and my 8am pills. I went to desk at 7:55 and asked for them. A nurse or tech or someone –I never knew and no one ever bothered to tell me who or what they were — lingering at the desk said that the med nurse somewhere in the back would get them. I wandered off, figuring it would take some time and she would bring them to me, which is what they did at every single place I have ever been. But no, by the time I thought about it again, realizing that she had never brought them, it was 8:45 and people were lined up for their 9:00am meds already. I signaled above them to the nurse at the med window that I had not gotten mine for 8:00am yet. She told me that of course not: I left the med station; why should she go after me? Then she indicated that I should get in line to be next…even though that meant stepping in front of someone else. Okay, so I got in line, and – oh, I do not remember all that happened except that I became angrier and angrier with her, resenting her attitude. As a consequence, I did everything I could do to irritate her. She poured the meds at the computer, where I couldn’t see them, saying their names softly to herself so I asked to see the packaging. I didn’t trust her not to withhold or add something I didn’t want. Because I had asked for Imitex an hour before I sensed she would not include it. Well, lo and behold: No Imitrex! So I took the pills, but asked her for the Imitrex as well.

Ah, revenge time! “I will get the Imitrex at 9:00 am sharp, when it is due. That is 10 minutes from now. You can come back and wait in line then.” I just stood there, not budging. I would never stoop so low as to impugn a person’s person, but I probably let loose a few curses and most certainly raised my already angry voice a few decibels. Finally, speaking in a calm, respectful voice, a man whose name I learned was Albert came up to me asking in such a polite manner that I even looked him in the eye, to “please just lower your voice” so he could hear me tell him what the problem was.” Well, treated in such a fashion I understood he would wait for me to calm and not get angry back so I was able to take a few breaths and then make him understand what she was doing…He said, with the med nurse standing well within earshot, though I do not think he intended any manipulation, “It’s okay, don’t worry. It’s nearly nine, and I’m sure the med nurse will get your medication for you.” (I was sure of quite the opposite but harrumph! Well, what could that SOB, excuse me, DOS — daughter of a stud (med-nurse) do but give me the Imitrex now?) I might have crowed, but instead, thanks to Albert and in respect for him, I took it without a fuss and thanked him again.

This sort of treatment gives the lie to what so many providers – both individuals and insitutions — say about the goal of “empowering patients.” What bloviated BS! What they really want are not empowered patients but cowering patients, people too scared and drugged up to object or make trouble in the first place and then who continue to cower before the establishment MD’s power structures all the way to the last place.

My butt hurts from sitting slouched on a bed all day. I need a break. So I am going to post this and go outside in the cooling darkness of the Litchfield hills and drink the air. Since I have nothing I have to do here but write, I will post tomorrow about that single meaningful encounter I had while imprisoned at The Institute of Living. If I still feel it is worth writing about, which as I think about it, it may not be.

Oh, what the heck: Basically, it concerned an encounter with this female tech, a woman who in passing me in the hallway, the first time she had spoken to me so far as I knew, accused me of moral turpitude (not in those words), made a statement shaming me for my behavior on Friday morning at the medication window. What had I done? By talking too loudly, I had made “the poor man behind [me]” cover his ears and point at his skull to communicate his displeasure. PLUS, I had made everyone wait a good 30 minutes…I knew the 30 minutes was an exaggeration, so I didn’t even touch that, but the shaming tactic got to me. I went back a few minutes later and said I wanted to speak with her. We went to a couple of lounge chairs in the hall and sat down.

“What precisely did I do that was morally wrong this morning?”

“Do you know you talked so loudly this morning that the poor little man behind you was covering his ears and pointing at his head?”

“So I should have talked more softly, but I do not have eyes in the back of my head to see him. I could not know he was communicating by pointing at his head. It is not morally wrong not to have eyes in the back of your head, nor is it morally wrong to speak in a loud voice.”

She reiterated the case of “the poor little man behind you pointing at his head.” But I continued to press her on what was morally wrong because I didn’t have eyes to see behind me. Finally she granted that I could not help not seeing him and that it wasn’t actually a morally wrong thing to do, to yell or talk too loudly. At this point I said to her, nearly in tears because just having a calm conversation had taken such effort on my part, “Be careful what you say to someone on this unit you know nothing about. Words have power and you should use that power with care. You have NO idea how those words you spoke affected me, no possible idea…”

She gave me an intent look, almost a fearful one, as if afraid that — well, no, I don’t think she gave a damn whether or not she caused me any emotional harm. She no doubt despised me along with the rest of the nursing staff. But perhaps she suddenly appreciated how even her words were important and powerful, and carried weight and could do some good but could also do just as much psychological damage and maybe more sometimes than the loud voice that damaged mostly ear drums.

Things really are stressful, not least because this lovely 17 year old cat refuses to eat and barely drinks…

It is too late to write much and I am much too tired, but suffice it to say that I am overwhelmed with sadness for, well, my father, my dying cat, and the stress of a face to face mediation that has been scheduled between me and the people who tortured me at that certain hospital about which I am always writing. You would think I would be happy to be getting somewhere but no, I feel only worn out and sad beyond belief. I wish I could look forward to it, somehow. But I just feel guilty, because I did not do anything to prevent their abuse. I should have refused to lie down on that restraint bed! I should not have gone like a lamb to the slaughter just because I was afraid…I should have just stood there and made them carry me over. Not fought or resisted just done passive non-violence…I feel so slimed that I actually went to that bed and lay down on it, naked (covered with part of a sheet, that they moved away to restrain my limbs so cruelly as to cause me exquisite physical pain…) I feel so guilty and so terribly sad. WHy didn’t I resist? Why did I do what they said to? I had always resisted up until then? Why did I let the fear of their assaulting me again get the better of me?! I cannot forget that, I cannot forgive MYSELF for it. I feel more degraded by that than by almost anything… I feel dirty and scummy and like a disgusting piece of garbage…

Most of what follows below is a cut and paste from past blog posts, plus the latest update, but I wanted to do so in order that newer readers would understand where all this comes from. And also understand why I am so adamantly opposed to the coercion of the Involuntary Outpatient Commitment bill.Although I am writing this on Sunday, April 1, I may update it further as the days go on…You might want check back in a while to see if there are other developments, though anything big will get its own post.

As I mention in the post below, I wanted to bring the incidents I describe to the attention of the office of Protection and Advocacy for Persons with Psychiatric Disabilities (Or Mental Illness). I did so, about 6 months ago, and after an investigation, they found that the hospital was wrong and abusive in their repeated use of seclusion and restraints. What is more, they referred my case to the Department of Public Health recommending sanction of the hospital and immediate amelioration of the conditions that produced such abuses. Alas, I believe this means essentially just a slap on the wrist and not enough monitoring or chart reading to really keep up with them or stop them from hiding the same abuses that have gone on there for years. After all, patients have known about it for years, but no one has said anything because they have not known what to say or known that they had the right to better treatment. Or something!

I do not think that merely sanctioning the hospital or telling them to “do better” will change anything in that culture of embedded violence. So I went to the local TV station’s investigative team to ask for an investigation, and I went back to the O of P&A with more information about how I was treated by the very same security guard during my ER visit this past February, when he grabbed and pinned my arms behind my back, without provocation and without cause. He had no right to so much as touch me and should never be touching psychiatric patients so liberally. Especially when no one was in ANY danger! WR who has been dealing with my case told me he is not going to drop it, is going to the supervisors and higher-ups and see what more can be done. I myself will keep at it. This will not rest. I do not want revenge but I do need to know that they will not keep doing what they are doing to others...I need to know that patients are physically and emotionally safe there and that the one security officer who is so abusive there is taken off the psychiatric service as a danger to everyone

________________________________________________________.

On my “On Psychiatry and Authority” post, especially about what they did to me at “Middlesex Hospital, I can now write with more accuracy. I gleaned a lot of the following directly from my records, meaning both the nursing and progress notes and the “event” notes, which should have been written after each and every incident in which they felt obliged to use measures against me involving involuntary seclusion or restraints, including such things as: physical/bodily/painful holds, physical/bodily/forced escorts, physically preventing me from leaving a “time-out” room, i.e. a seclusion room, as well as a locked door seclusion or the dreaded four-point restraints . I have also used my own journal writings here as counterpoint, some entries of which were penned as soon after these things happened as possible — that is, when I could obtain a writing implement.

The first time I wrote about the particular incident I focus on here, I did not understand why I was naked. Having read my entire medical record from the stay, I now understand more about what happened, so I will start this account where it really began, somewhat earlier in the day. Also, and this is important, while they perpetrated a criminal act on me in this incident, there were others later ones as well. During those, I am described in words that make me sound as if I have gone something near berserk…though not in those words of course. Now, there is no context given, nothing is said, not a word, of what the staff is doing TO me or with me at the time that I am going so wild, but nevertheless, the chart describes me as biting and kicking and screaming and peeing on the floor and smearing urine all over the walls…and then there are repeated use of restraints and locked seclusion where neither were “necessary” and were always destructive and traumatizing. Well, unfortunately I have no journal entries after that first time. Why? Perhaps because by then they had drugged me up on Keppra (having decided I could not take the 2 separate ones I came in on though they worked fine and without side effects ) an anti-seizure med that made me so dizzy I literally could not walk, and my vision so blurry that I could not write even if they had not prohibited the use of all writing equipment. So I can recount here only the most egregious incident, the one that I believe triggered for all the others that followed, the one after which “all bets were off” as to any future “behavior” on my part, and from which I emerged so traumatized that I didn’t give a hoot what they did to me after that…

Before I get to it though, I want to briefly recap where I am in my struggle to recover from the trauma that this stay at Middlesex Hospital occasioned, which only increased the trauma already inflicted 6 months before at Manchester hospital. Up until the night before last, as you know, my state of terrible upset had been growing worse and worse, so that I’d gotten to the point where I could scarcely think about my 6 week stay at Middlesex without becoming nearly hysterical with trembling and anger and anxiety and terror all mixed up together. I felt as if death impended, my heart pounding wildly, fear screeching like a car swerving at high speed until it nearly hit a bridge abutment. Every night, every day it comes back even now (new edits 3/2012) as if happening again. Then one night, I wrote the blog entry about Trauma and Acceptance, and I began to try to think about things differently. I realized that I could parcel out thinking about Middlesex little by little so the trauma of it didn’t have to eat me alive. I realized that I might be able to save my sanity, and spare my life from total destruction at the same time, if I decided to accept what I could not change, the first step of the Serenity Prayer.

Wonder of wonders, after two days of not letting the trauma appear on my radar screen, except insofar as I gave a talk about it for the Farmington, CT, NAMI book club last night, which included reading the Acceptance blog entry as its conclusion, I have made an astonishing discovery. Up till now I had had almost complete amnesia for the Middlesex hospitalization. However, it seems that as I remain or try to remain calmer, certain episodes are coming back to me. Not fresh, not by themselves, no, but when I read in my journal or even in the records something that I did not recall on my own nor even believe was true it feels, well, possibly real, and I can just begin to “get” a sense that indeed it feels familiar, that perhaps I did do that, did say that, that it did happen, even if I would not have remembered it without the journal jogging my memory. I am wary of induced false memories, but in this case since I have records of the bare bones of what did in fact happen, I have to try to trust that at least some of what I am retrieving is not pure confabulation woven from only my imagination.

I cannot bring my mind any further down that memory path yet. But I suspect now that I formed some memories after all, that they are simply buried for some reason, and that perhaps the trauma and fear have kept them from me. Now that I can relax a bit and not feel so angry and terrorized by my amnesia and by the one clear memory I have, perhaps some, if not all, will slowly return. Since I prize my memories — they are all I have and without them I have had no life, — I want them back, as many as possible bad as well as good.

Now let me continue on to the account of Middlesex hospital in late April, 2010 and the first time they put me in 4-point restraints.

During the MD visit the morning before, Dr N wrote: “Patient later ..(?) ..to me that she didn’t trust anyone, that no one wants to help her and she is being punished by staff. I repeatedly said that she is not being punished and she is projecting….Patient escalating tension with staff. Rigid. Wants to die. Wants to sign 3-day paper to leave.” (It is not clear what he means by “later” — did he write this after the episode of restraints, when I did in fact tell him that they punished me? It seems likely. IN which case he did not listen to anything I said…)

RN note 1:30 PM: “Alteration in thought: Patient continues on constant observation. Continues negative, irritable, testing limits. Refused initially to shower, then changed mind and agreed to, then wanted to walk out of shower into dayroom naked. Agreed to dress after informed security called to unit…”

About these notes: one, what was I projecting in thinking they wanted to punish me? What? And it is typical that Dr N blamed me for “escalating tension” with staff. I wonder if he ever saw how they worked, saw in action the mechanism by which they’d cause an escalation. 2) Most likely, in this case, I was threatened that if I did not shower I would not get off 1:1, so I “changed my mind.” And it seems to me that if someone “wanted” to get out of shower and walk into dayroom naked, it is a matter that the nurses could handle and ought to. I weighed all of maybe 98 pounds then. And if they had closed the door and made me dress, they could have. Why call security unless they wanted to threaten me, terrify me? That was neither compassionate nor caring. Methinks it was, aha, punishment.)

Moving right along…

All the details that follow are “accurate” insofar as they are derived from official documents or my journal. Accurate in that sense. But remember that in the records, NO context is ever given, the behavior of the staff is rarely described, or only in the briefest and most self-serving ways. NO context is even given to MY behavior.

The nurse who wrote up the night’s notes says that I was angry the entire evening and demanded continuously that she call the on-call doc to discontinue my 1:1 status. For some reason she writes that I was “unable to follow directions” when she tried to assess me for, I presume, safety, perhaps so I can get off 1:1. I don’t know what she is talking about here, but it is typical that the nurses cared only about a patient’s taking orders and following directions.

Anyhow, at around 7:30, she wrote that I “walked into the dayroom” and according to the RN notes, without any provocation (which is highly doubtful) began shoving and turning over chairs and then picked up the patient trash can and put it over my head. Although at that point the staff told me to “walk with them to the “time out room” I refused and “went to bed instead.” (That was written in the chart: I WENT TO BED INSTEAD.) Now, you would think that this would be fine, after all, would not they want me to go to bed and calm down? But no, I had not “followed directions” and so of course “security was called and patient required security to carry her to time-out room as she refused to move or walk.” Remember that this “time-out room” is exactly the same thing as the “seclusion room” — it is the same room, with the same “withouts” — without heat, without windows, without anyone to talk to, without blankets, without a toilet, without anything to make one comfortable…just a thin mat on the linoleum floor, unless they have taken it out. So they barged into my room where I had gone to calm myself down, and picked me up bodily and carried me to the seclusion room. That means by definition that they physically restrained me and physically, forcibly escorted me to the seclusion room where they prevented me from leaving, all of which are NOT permitted except in the case of “severe and imminent danger to self or others”…(so an event note should have been written up and a physician’s orders should have been gotten). There I took their Ativan and was told that I had to stay in the room for 30 minutes. Why not in my own room for 30 minutes? Because time spent in the time-out room is a punishment. Parents make children stay in a time-out room (usually their bedrooms!) when they don’t obey. Why? Because that’s their punishment. But staff doesn’t punish. No, they don’t punish…

Now this is how I remembered it the next morning in my journal: “I had been told to go to the time-out room, which I did voluntarily…” (apparently I did not remember that I had been physically carried there, but there is some confusion in the records too, because I went and then left and then was carried back…). “But it was cold and they wouldn’t give me a blanket so I didn’t stay long…This only led to more goons pushing me back into that cold and sterile room, this time strong-arming me and forcing me to a seated position on the mattress before quickly leaving but not locking the door.”

The nurse wrote it this way: “Patient refused to stay in time-out room, attempted to shove staff, kicked at staff to get out of room. Patient was instructed several times to sit on mattress and stop pushing at and kicking staff. Patient refused. Seclusion door locked at 7:55pm…”.

At this point both records agree that I stripped off all my clothing. But the official records state only that fact, and that I “was changed into hospital garb” but in my journal I write something entirely different and rather revealing: Left alone in that cold and sterile room, I decide “they’d have to give me a blanket if I was [naked] so I quickly undressed and just hid under the mattress for warmth. This caused a stir for some reason and I was forced to put on hospital pj’s and lie down on the mattress. This would not do, not without a blanket which they continued to refuse me so once again I got up and tried to push through the woman barring the unlocked door. She called for reinforcements and they came en masse. (Note: I spelled this “unmasse” — a dyslexic spelling of the first order. This is a symptom of my acute neuro-Lyme disease, since I was always a first-rate speller and would never have had difficulty with “en masse” had I not been in the middle of a flare up… as they knew full well).

“At this point” my journal continues, “they again subdued me and told/asked me why I was fighting. I said [it was] because i needed someone to talk to. That was all I wanted, just someone to talk to. The security guard seemed taken aback. All these personnel hours wasted when all I wanted was one half hour of one person’s time? It seemed to strike him as ludicrous as it did me….

“Why don’t you just ask to use this room when you feel anxious or upset?” he then asked me.

“I do, I have!” I replied

“Well?

“They always say it has to be reserved for an emergency.

He seemed completely flummoxed by that reasoning but there was no arguing with Policy so he fell quiet. Finally they decided to leave, telling me to be quiet and lie down.

I did. I did. But I was cold and I begged for a blanket.

“Sorry, it is too dangerous. You will have to sleep without one.”

That was it, I’d had enough! I dashed at them head first and they parted, only to grab my arms and try to stop me. Someone twisted my right arm and held it behind my back, but I knew how to get him to stop it, so I tried to bite him and he briefly loosened his grip. I twisted my own arm back to me and my left pinky, held, closed tightly onto something, hooked so tightly it wouldn’t budge. My legs, the right one, grabbed the thin leg of a woman behind me, making her lean back off-balance and lose her grip on me. Then I switched to holding both my legs in a death grip around the legs in front of me. It didn’t matter one iota that [I had taken off my clothes again to get a blanket and] was naked…Anyhow, they eventually overpowered me and got me onto the hard floor, my cheek on the dirty linoleum and breathing dust. At first I struggled but then I realized that the less I did so, the less they applied pressure (there must have been six people or more holding me face down on the floor, one of them practically sitting on me…).

Finally I stopped resisting and they let me sit up, finally giving me a blanket or sheet to cover myself with. The room cleared as everyone left except for one nurse, who was on one to one with me. She apparently was now allowed to talk with me and we conversed calmly. The door to the seclusion room was also now open.

However, there was some soft talking outside the door and I heard someone walking down the hall and opening a cabinet. I had a bad feeling about it and asked the 1:1 nurse what was going on. “Don’t worry. They are just getting you some meds or making up a bed for you.” This gave me a very bad feeling, and I suddenly understood what was going on, “Uh uh, they can’t put me in restraints, I am calm and it is illegal to restrain someone who is calm. You know that.” I said that again loudly, loud enough so whoever was down the hall could hear me. I began to tremble, but forced myself to remain as composed as I could. Another staff member then came into the room and asked me to come down the hall. Did I need an escort or could I do so myself. “Oh I can walk by myself. But you can’t put me in restraints, I am calm and it is illegal.” Nevertheless, I followed her to the empty room — I felt like “dead man walking” when I saw indeed that they had fastened restraints on the bed. The room was filled with staff members and security guards. I told them over and over that I was calm and willing to take PRN meds. I said I knew they were punishing me and that they knew it too. No one said anything except to reiterate that they would assist me if I did not lie down on the bed myself. I was so terrified that they would assault me and hurt me, terrified of the fear itself, that I simply got it over with, lay down on the bed, naked, and let them do what they wanted to do, gritting my teeth when they removed the blanket that was covering me. Well, here is what I did not remember, the account after that from my journal:

“Well, you know that despite my complete lack of resistance, they shackled me 4 points (badly as their restraints did not actually fit the bed — restraints are supposed to keep the arms at your sides not below the level of the bed, and your legs are not supposed to be spread-eagled! I protested this fact but not so loud as to disturb others [when they released me] my back hurt so badly I could barely walk and once more my scapula muscles felt as if they had been separated.”

“I plan to sue you for doing this to me.” I said calmly to all as I left the room. Nobody reacted…I woke in severe pain, the muscles in my chest felt torn from those that connect it to the shoulder, the pain went clear through to the scapula.”

Nursing notes were rather different, and I think were written after the fact, and hastily, perhaps not exactly ‘fact-checked” for accuracy after all. [Did a family practice doctor really see me? I do not believe so…why else would I not tell anyone about the pain, which she reports as non-existent.) But here is what she writes about the “scuffle” in the seclusion room:

“Patient was changed into hospital garb which she also stripped off. she demanded a blanket which was not given due to concerns about her tying it around her neck. [Note that I was ALWAYS under one to one surveillance!] She was encouraged to put the johnny back on and she refused. After staff left the seclusion room, patient placed mattress over herself where no staff including her 1:1 could visualize her. When staff entered room and removed mattress, patient again darted toward staff and attempted to flee. Pushed at staff, then kicked at staff, and attempted to trip staff wrapping her legs around RN’s leg. During the scuffle patient ripped bandage off her leg and yelled, “I have AIDS. I didn’t tell anyone that before!” She refused to remain in locked seclusion without attempting to harm others. Patient covered with sheet and walked to empty patient room where 4 point restraints were applied. Patient continued agitated initially then was quiet lying still.” [Patient can come out of restraints when able to refrain from aggressive behavior towards staff and property and can follow directions.]

Now you get the picture. I was put into restraints as punishment, but as an excuse for it, they made up a reason, which is is how I can get out of them: stop being aggressive towards, 1) staff ( remember who dragged me into seclusion room? I had gone to my room and they dragged me out of it just to teach me a lesson in the punishment room! 2) property – I was a danger to property… I do not think somehow that danger to property is one of the reasons a person can be put in restraints in this state or this country. And the danger was that I had put a wastebasket over my head! 3) following directions, well I won’t even go there. Just look at those “justifications” for keeping me in restraints and you will see just why I know they “had it in for me” that particular episode, but in fact were trying to get me most of the time I was there.

Be that as it may, I have contacted the Commissioner of Mental Health, and hope to contact the Office of Protection and Advocacy, which oversees the private hospitals in the state as opposed to the state hospitals, though I do not see why the commissioner is not involved in any hospital that takes state money, as all the private ones do…And seeing as I am a Medicaid patient when hospitalized, I would be a state patient were it not for the private hospitals being forced to take such patients in this economy, whereas years ago they could pick and choose, and did.

Finally, the MD’s “event note” observes upon exam in the restraint room that the patient is “generally agitated, very verbal, lying in bed with the help of staff and security to calm her down…” I beg your pardon? Calm her down?! I was being restrained, one, and two, I was being tied to the bed with my arms over the edges of the bed, below the level of the mattress, and my legs were spread-eagled –I was naked, remember? and all of them knew it.

So that is all I have to write tonight. I am appalled. What sort of people could do that to anyone? Who were they once, and how did they become so jaded and cruel? Surely, as nurses, they must have once been idealistic and good-hearted and compassionate. Most people who go into nursing are and I doubt that many go into it for the money or for any other reason than that they care about people. I simply have never met any young nurse who was not idealistic and caring, but I suppose there might be one or two. So what happened to this group? Could it be their own “society” is not supportive, is backbiting and so lacking in cohesiveness that they take out their own frustrations and lack of positive feedback on those patients who least please them?

I dunno, I have been told that this mechanism is sometimes at work on units where staff behavior is out of control in such a way. But what made them in fact so much into control and coercion at all? Why were they not themselves empowered by compassion and kindness, which would have fed them better as it fed the patients better as well? How did it come about that they learned the wrong lessons? I don’t know, and probably will never know. But I did catch a sense of these strengths in one or two of the nurses, just buried in fatigue or long ago burned out…

Too many were too personally invested in the patients liking them or in behaving for them in such a way that made their jobs easy! That was stupid and nonsensical. Why should the patients have to be or do anything for the nurses? The patients cannot control their illnesses and staff forgot that in their own need to be in control and to have their own need met by their patients. I think that is what it comes down to: at Middlesex, the staff’s needs were not being met by each other, or by the supervisors and colleagues, so they looked outward, and who did they expect to meet their needs but their patients, who could not, and could never do so. So they tried to make them, force them to. Or at least to toe the line and make each day quiet and easy to get through. What a farce. What a lousy place to be sick in, what a sick place to try to get well in…

I did the last two of these at Natchaug Hospital this past winter, both of which may be obvious. The first, Under Attack from All Sides, was meant to express how I felt at the time, with the fingers pointing at me literally showing what the voices do, and the red high heel with a hand, strong, hefting that lethal looking spike — well those both belong to a certain someone I cannot name who wants me deader than dead and will do anything in her power to achieve it.

The second of the hospital pieces (I did others, but alas I gave them away and so never did have a photo of them to share…) is the last one posted here, the Ogre that Ate Manhattan, which is written partly in Spanish and partly in acronym. The message is KILL the Orgre that Ate Manhattan, but I figure you don’t need to understand that to enjoy the artwork…Not quite finished yet, but there is not a huge amount left to go…

Finally at the top is In her Hands, which is not done, though it may look it. This is a partly 3-D high relief piece, and partly a flat piece of acrylic painting. In truth a lot of it is optical illusion but not as a joke. The detail shows how her hands are painted onto the globe, not actually three dimentional at all; they just look 3-D because of how I painted them. I need to write more about more “important” things in my life, but for now this will have to do. (Addendum: I realized, days later, that I must have written the text of this very late at night, and possibly after I’d taken my Xyrem, the narcolepsy night time med. Why? Because a great deal of it was so badly spelled and some of it made no or little sense at all. I mostly do that sort of thing, dream talk, if you will, when I make the mistake of trying to write after I have taken my medication and get busy and forget that I am not “with it” entirely…so I am not aware when sense devolves into gibberish! Forgive me, anyway, if I seemed somehow sloppy if not wholly out of it!)

The above poem tells a long story in a few words, though necessarily only part of it. I have to leave it there for now, as I lack the energy to flesh the story out further. But in later days, after the memorial service and as the spirit moves me, I will try to write more. Thanks for your patience. As a good friend said, It — grief, tears, feeling alone or lost– comes in waves, but when it hits, it hits hard…

Perople have died in this restraint chair -- in Guantanamo, yet they made me sit in one in Manchester Hospital in Connecticut, 2009

Some memories are returning. Not a great many but this one was triggered by something I heard briefly on television the other day, simply the mention in some other context, of the words “restraint chair” and in an instant I flashed back (and I use those two words advisedly, since I do not actually know what is meant by a “flashback”) on something that happened when I was a priso…excuse me, patient, albeit involuntary, at Manchester Hospital in the fall of 2009.

This had been an extremely brutal stay up till then. When I was admitted the psychiatrist I was assigned to Dr BZ — I have written of this elsewhere so I won’t recap the whole thing, as memory is fickle and I may have misremembered it by now — stopped most or all of my meds, saying that if I was there, clearly they didn’t work. Then he swore I would take the one drug I refused to take: Zyprexa, and he scheduled a forced medication hearing, which naturally I would lose, having no power and only my word against his as to whether or not I needed it. Well, I did lose it, but inexplicably, and sadistically, instead of forcing on me a drug that by all accounts helped me, he changed this to TRILAFON, an old drug that did nothing for me and only made me completely miserable.

The upshot was that every time they came to me with medications, I flatly refused to take the Trilafon, even under the threat of a Haldol injection, The goon squad was called, and since I refused to quietly accept my punishment, they assaulted me, stripped me, and forcibly injected me. This got to the point that they started four point restraining me to the bed, just to inject me…And it because such a routine that to avoid the “tiresome process” of getting out the restraints they simply left them attached to my bed. I know this not because i remember it but because my friend Josephine told me she saw them.

Me? I was so snowed by Haldol most of the time, that I could never even find my room, and had a sign in large letters taped to the door so I would simply recognize it when and if I managed to find it. Also, I was so dazed that I had to wear red slipper socks as a fall risk…but no one ever decided that maybe this was due to the drugs they were giving me!

Anyhow, one day, one day…and here is where memory kicked in after hearing those awful words on TV: one day the nurse who was most in charge of the daily torment, came to the door with another nurse pushing this large chair, and i recognized what it was at once. I had seen them before, having reviewed a book a long time before for the LA Weekly on the treatment of the mentally ill both in hospitals and prisons, a book, moreover decrying “barbaric treatments” of the past.

“You aren’t going to put me in that, are you? I’m not coming anywhere near it!” I shrank away from them and ran to the other side of my bed.

“We won’t restrain you, not if you behave. But we want you to sit in it for today. There are no restraints on it now. It is just a comfortable chair. Come, sit down. The student nurse will be with you all day today.”

Then they essentially forced me to sit down and stay in the chair. Or else…I was terrified. and the student nurse knew it. Luckily, she would turn out to be a kind and wonderful young woman (her experience at Manchester almost drove her away from psych nursing, but as it turned out she discovered Natchaug Hospital, and became one of their most beloved nurses). As she told me later — because memory mostly fails me here, but for her reminders — she did Reiki with me, the practice of nearly touching a person but not quite, and moving her hands along my body, not sure how it works or worked, but she later told me, at Natchaug, that I responded well to it, and stayed calm all day. I even as she said, took my meds. Which means I actually swallowed the Trilafon, probably because I couldn’t bear to have another fight in front of her.

Whatever was the case, if Reiki is as I described it, no wonder I responded well, as it was a NON-physical therapeutic way of dealing with me, non-assaultive, gentle, non-trespassing and non-brutal. Why the rest of them could not have followed suit or come up with some other way to treat me as she did, I will never know. Clearly they learned nothing from her; she left and likely they are back to treating others as they did me.

I believe they would indeed have used that chair as a restraint chair on me. I do not think they brought it in just as a comfortable chair, I believe it was to intimidate me, to cow me, but I think too that they were in fact prepared to use it. I do not have the slightest doubt. I would put nothing past those people who so brutalized me as to put me in four point restraints over and over during more than 8 days. For all I know it might have been more than eight days. I simply do NOT know, as amnesia has sealed up much more than memory preserved.

Enough for now. I need to write tomorrow about the Versatile Blogger Award that DogKisses gave to me. I am shamefully late in thanking her. And I do not know how to place the badge on my site, but she was such a lovely blogger to do so, that I do owe her her own post of thanks and appreciation.

Although it is only 10:30pm, I seem to be falling into dreamtalk as I write this…I must be sleepier than I know, and half asleep or falling asleep every so often as I write. I say this because I came to a couple of times already, only to find a paragraph of weird gobbledygook on my post. If this happens again, and I do not recognize it until tomorrow, forgive me for sleeping and writing this with the consciousness of a bad dream only. I plan to proofread this entire thing tomorrow, just to vet what I did write.

The subject of this post says it all. I have been exposing myself to “the problem” ruthlessly for months now, and to no avail. I still suffer from the same symptoms of what would be PTSD (had not the good doctors redefined the word “trauma”) and I cannot in truth say that they are any better. Yes, I do remember a little bit of what happened, more than I did before (for those who do not understand the reference, see my Oct 7, 2011 post titled “Psychiatry and Authority: Restraints Update”). At least it can be recalled to me by other means and I can assent to it with some sense of Yes, I do remember that happening…But as to the tears and trembling and heart racing etc I see no improvement, and if no- improvement after these many months of self-treatment is less than to be expected, then I would say that not only has exposure therapy not helped me, it has made things worse. Rather than being literally therapy, it has only added “insult to injury” or as I put it, laid salt on the wound.

I do not know what to do about this. I find myself irritable, even irascible, especially with family members who I believe did not care enough to rescue me from the clutches of malignancy when they knew it was going on. Indeed, they in fact did not either care or do so. But that is the same old story and I can beat myself over the head with their inadequacies as family members, or I can simply wave them away as inadequate in such matters and go on…Ah, but how to go on? How do I continue to live despite these horrendous feelings and constant on-the-verge tears? Even Dr C seems at a loss, though I am not sure why. Surely she must have dealt with trauma — or “trauma-like situations” (since this wasn’t Katrina or the tsunami, so by definition it wasn’t trauma…) before now. Surely she ought to know what to do about this situation. Why then does she seem so helplessly unable to tell me what to do or to help me get over this? Why won’t she give me any advice or help? I can barely go on some days and yet she never offers anything but a mirror to myself, to what I might think or feel. I tell you, I can hear the professional technique in her voice sometimes, even as I fall for it.

Yet I really like her and I don’t know why. Is it because she does NOT order me around the way Dr O did? Is it because she is NOT authoritarian and directive the way Mary was? I dunno I just know that she listens to me and takes me seriously, does not consign every idea I have to the dustbin of delusion as Dr O (Mary) did.

Nevertheless, I still do not know what to do or how to get over this problem, and even though the OPA has decided in my favor and is sending my case on to the the Dept of Public Health for further action, even that doesn’t relieve me or help my anxiety and anguish abate. Why should it? What is done is done, and the consequences are as they are. My problem is how to go on, how to survive, how to deal with the result and get on with life. But so far I have not figured out how. Despite my talk of forgiveness and acceptance, I have not reached that state yet, not perfectly, not even adequately. If I had I would not be so torn apart. I believe in forgiveness as the healer of all, but when push comes to shove, I cannot seem to take my own advice any more than most other people can.

Yet I see that I resent so very much and it does not all have to do with the restraints issue. Some of it is much larger and concerns a general anger or resentment towards how certain people and family members have treated me over these past decades, issues that have not even yet been resolved. This — my anger — doesn’t endear me to anyone, and it solves nothing to go there, to decide and then rage against whoever did “this” to me.

I do go there, of course, or I wouldn’t be complaining of how they tortured me. I torture myself with these things. And I get irate and start sobbing and write angry emails that likely no one understands the genesis of, though I make the assumptions that they will be obvious to the person on the receiving end. Yet the grievances are real. It is just that it is useless to bring them up, not so much with others as for me. What good does it do to cry over what happened twenty or thirty years ago, even if it continues to happen now with the same person? I ought to have learned something over those intervening years and that is that the person is not going to change and that their injurious nature, their manner of hurting me is going to continue no matter what I do or say to them. Either they do not care or they simply have no idea or understanding of the impact of what they do or say (or do not do or say) has on me. But in the end it is I who must continue, must soldier on, and I should have learned to do so without their support or confidence.

I have, I have. It is just that a little improvement in things fooled me yet again into expecting real change, a real difference, a genuine affection and positive behavior towards me. Instead, in both cases, I get the same old, same old, just dressed up in affability and pretend benevolence until I cross them. In one case, it is egregious, and the reaction is fury, the greater the truth I point out, the more massive the indignation and rage. In the other case, the sheer oblivion to the hurt caused is cause for massive hurt itself. And both people continue to pang me today, either on purpose or because they cannot help it. In the one case, I believe it is in fact deliberate. In the other, perhaps not so, but from personal weakness. I can try to forgive the latter, but the former is just too galling and it behooves me to stay the hell away from that person…as that is the best I seem to be able to do to protect myself at this point.

Well, without respect to the above discussion, which was vague in the extreme because I do not believe I have real privacy here and you never know who might linger around to read, despite all that, I want to show you a new piece of art I did over the last two days. As art it is nothing, though it is the first time I have attempted a scene with multiple “characters” actively engaged in physical activity, so in that sense it was st least personally challenging. But the scene itself may be instructive, if horrifying to some people.

I am only going to post the initial sketch and the final version, plus some details from the drawing as it is good to get a closer look at parts of it that a monitor-size photo cannot give you. The original is at least 24″ by 17″ so it is reasonably large and has room for more details than my usual 11″ by 14″ drawings.

Just had to erase a paragraph of complete “dreamtalk” here, and fearing that I may descend to such incomprehensible language again, I will hereby cease and desist in the verbal production department and just upload the two photos. First the sketch and then the final colored pencil product. Both are very closely connected with the trauma that I wrote of at the outset and the drawing was part of my next attempt to “expose” it out of me. Whether it did or did not, I will find out on Jan 6 -9, 2012, when i go back to Wisdom House to write for the weekend. If I cannot do more than continue in this vein, then I will have an idea of how little I managed to help myself. But I am hopeful that this will finally prove to be a working solution — to draw what happened on paper but then to write about dealing with my anger and resentment and other feelings, which is really what is important at this point, not with the “mere” facts of what happened. If it is, I will be very proud of resolving at least part of the problem on my own.

First of all, I’ll post the sketch, as it will print out above the text as follows.

Who is Smiling at this Image of Torture?

A picture in graphite and later in colored pencil depicting with absolutely accuracy the sort of thing that a “take-down” by a hospital goon squad can entail before they force a person into four-point restraints. The nearly naked person in this depiction is, of course, me at a certain hospital…I am afraid that as I look at this version (correctable) the smile has turned into a grimace on the face of the white woman in the foreground. THat needs to be tweaked a bit…I also note that there are NO SHADOWS… But this is almost more of an illustration than a real drawing, so I will forgive that lapse. Next to come I hope will be a painting.

Here are some photos of details:

I realize that it looks like “I” am lying both on my back and on my stomach, but that is an illusion of the photo. In reality those are the backs of the legs, not the front.

Enough for now. I need to wake up and then I want to discuss the book, ANATOMY OF AN EPIDEMIC. Perhaps in my next post.

I am not sure what to think of this video. I certainly did not give permission for it to be used, nor did I approve of the final product. But I would welcome all opinions, should anyone wish to share. Please do not click on Like or Dislike buttons to give opinions. That only tells me you dislike my posting it, not the video itself…But maybe I am too sensitive.

I see that it will not insert directly here so I am placing the link to it here instead.

As for the update, well, I sent most of the important material from which I derived the last blog post about the restraints episode to the Office of Protection and Advocacy and by the afternoon of that very same day, I got a call from them telling me that they were going to do an investigation! Not maybe, but yes. This was quite a surprise. I did not expect to hear from them so soon, much less so definitively. They do not take every case after all, but pick and choose from the many complaints that come their way. I have run into so many roadblocks that I was afraid that there too I would be shoved aside for other more important matters. But no, I think they too found this matter outrageous.

So I will keep you posted as to what happens. They want access to my chart, which I will give them, but I will also fax them the pages from my journal too, as I want them to have contradictory accounts to counter what the “official” record says. Though that says enough that is not quite legal by itself.

I have been cleaning my apartment for 2 days and it is still a wreck, but I need to frame all my artwork for a show I will be doing in early November, at OpenStudio Hartford and I cannot do anything until I have space in my apartment. It is getting better, at least there are “paths” to walk through! But there is still a lot to be done, and I am already very tired of cleaning. How on earth do I make such an atomic mess of things so often? So needless to say I cannot write much today, but I did want to let you know of this latest development.

“In India when we meet and part we Often say, ‘Namaste’, which means: I honor the place in you where the entire universe resides; I honor the place in you of love, of light, of truth, of peace. I honor the place within you where if you are in that place in you and I am in that place in me, there is only one of us." ~~Ram Dass~~

“In India when we meet and part we Often say, ‘Namaste’, which means: I honor the place in you where the entire universe resides; I honor the place in you of love, of light, of truth, of peace. I honor the place within you where if you are in that place in you and I am in that place in me, there is only one of us." ~~Ram Dass~~